EP 723 Postoperative Cognitive Impairment Following Open and Laparoscopic Colorectal Resections: A Snapshot Review from a Tertiary Care National Health Service Hospital
Mukhil Rajendran, Mohamed Yasser, Ashan Dassanayake, Mirza K Baig, Christie Swaminathan, Muhammad SajidAbstract
Background
Postoperative cognitive impairment (PCI) is a recognized complication after colorectal surgery (incidence ranges from 12–35% within 72 hours), particularly in older patients or those with comorbidities. PCI is associated with prolonged hospital stay, increased morbidity, delayed recovery, and potential long-term cognitive decline. This snapshot review aimed to quantify PCI incidence in gastrointestinal surgery patients at a tertiary NHS hospital and assess the feasibility of structured cognitive screening using the 4AT tool.
Methods
This observational study included 20 consecutive adult patients undergoing colorectal surgery, with retrospective and prospective data collection. Variables included demographics, surgical approach (laparoscopic versus open), indication (benign versus malignant), perioperative morbidity, and sepsis indicators. Postoperative cognitive status was assessed on day 3 using the 4AT screening tool. Descriptive analysis evaluated PCI incidence and potential associations with surgical approach and patient characteristics.
Results
The cohort included 9 males and 11 females, with 13 laparoscopic and 7 open bowel resections. Surgical indications were colorectal cancer (n = 4) and benign conditions (n = 16). PCI was detected in 1 patient (5%) on day 3. No mortality occurred. The observed incidence was lower than reported in previous studies.
Conclusion
PCI is clinically relevant but potentially preventable complication following colorectal surgery. Routine cognitive screening with tools like 4AT may enable early detection. The low incidence in this cohort suggests that effective perioperative management, early mobilization, and careful patient selection may reduce PCI risk. Larger studies are needed to confirm these findings and establish best practices for PCI prevention and management.